The occurrence of cardiovascular lesions in individuals with rheumatoid arthritis has been recognized for many years.1 Manifestations attributed to the rheumatoid process include valvular, myocardial, and pericardial lesions,2-6 as well as systemic arteritis.7,8 Arteritis of the coronary vessels has been found at autopsy in as many as 20% of the cases,9 but only rarely has this complication been diagnosed during life. The clinical diagnosis of acute myocardial infarction due to rheumatoid coronary arteritis was not reported until as recently as 1967,10,11 although the pathological association had been previously recognized.5,7,12
We describe the clinical and coronary cineangiographic features of a patient with rheumatoid coronary arteritis in whom angina pectoris was treated by a saphenous vein aortocoronary bypass.
A 35-year-old white woman was admitted to Rush-Presbyterian-St. Luke's Medical Center on May 9,1971. For several years, the patient had been experiencing oppressive precordial pain and